title: [A fatal case of small cell type undifferentiated carcinoma of the esophagus with sudden diarrhea and bloody discharge by CPT-11].
abstract: When a male patient(age: 63)came to our hospital to report his discomfort in swallowing on February 16, 2005, we observed that a tumor of the subcircular type 2 had invaded his descending aorta directly, which was equivalent to the range from tracheal bifurcation to esophagogastric junction. At the same time, we found multiple metastases in lymph node which were from both cervixes to the range around the aorta abdominalis, and pleural effusion on both sides. We diagnosed them as small cell type undifferentiated esophageal carcinoma(T4N4M1, Stage IVb)with esophagus lesion. We started chemotherapy with irinotecan(CPT-11)and cisplatin(CDDP)in accordance with the guideline of the treatment for lung small cell carcinoma. Five days after we began the chemotherapy, leukopenia(grade 4)and abrupt bloody diarrhea were observed. Although we conducted intensive care, on day 7 he died of multiple organ failure caused by sepsis. Pathologic anatomy reported was necrosis of intestinal mucosa which ranged widely from his duodenum to rectum. We reported this fatal case of small cell type undifferentiated carcinoma of the esophagus caused by treatment with CPT-11, which triggered abrupt diarrhea and bloody discharge.
authors.affiliation: Department of Surgery, National Hospital Organization Osaka National Hospital.
authors.forename: Toru
authors.initials: T
authors.lastname: Masuzawa
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Fujitani
authors.forename: Motohiro
authors.initials: M
authors.lastname: Hirao
authors.forename: Masaki
authors.initials: M
authors.lastname: Kashiwazaki
authors.forename: Masakazu
authors.initials: M
authors.lastname: Ikenaga
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Mishima
authors.forename: Shoji
authors.initials: S
authors.lastname: Nakamori
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Tsujinaka
authors.forename: Masashi
authors.initials: M
authors.lastname: Takeda
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002166:Camptothecin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018288:Carcinoma, Small Cell / Q000150:complications / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D002454:Cell Differentiation; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use; D003967:Diarrhea / Q000097:blood / Q000150:complications*; D004938:Esophageal Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D017809:Fatal Outcome; D006470:Hemorrhage / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D000077146:Irinotecan; D008297:Male; D008875:Middle Aged; D017211:Treatment Failure
chemical_list: D000077146:Irinotecan; D002945:Cisplatin; D002166:Camptothecin